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Re: vbac on demand From: verner nellsch (vnellsch@eastex.net) Sun May 11 20:15:56 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: verner nellsch: "Re: vbac on demand" Previous message: rebecca smith: "Re: Methotrexate for ectopic" In reply to: Garry E. Siegel, M.D.: "Re: vbac on demand" Next in thread: Efrain Ramirez: "Re: vbac on demand" 1. i am an ob/gyn, practicing in a small town an hour outside of houston. i am boarded, but not grandfathered. i have been doing this for 30 years. 2. thanks for the input. good idea, bad for time management. as the hours drag by, and no dilatation and softening of the cervix or the woman's determination, do you try to ship her, if you can get someone to accept? i do vbacs, but i am about the only person still doing them outside of houston. vnellsch >----- Original Message ----- From: "Garry E. Siegel, M.D." <garrys@mindspring.com> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net> Sent: Sunday, May 11, 2008 10:10 AM Subject: Re: vbac on demand > 1. I may have missed this--Dr. Nellsch, please introduce yourself to > the list. > 2. That said, ACOG has does not think that a VBAC is appropriate after > two cesareans in the absence of a prior vaginal delivery. This is > simple--tell her you cannot participate in a VBAC and that you advise a > Cesarean now. If she refuses, have her sign a homemade refusal form. > Since one can't operate on someone without consent, you're stuck sitting > there with her until she labors/delvers or agrees. Then, all in the > anesthetist and OR crew and ask them to sit with you. If they > won't/can't/refuse, time to call the chief of staff and head nurse. > > That's my 2 cents. > > Garry > > Killing time waiting for a flight from Madrid to Rome with the family :) > > At Sun, 11 May 2008, verner nellsch wrote: >> >>question--you are an ob/gyn on call for a small community hospital (3 >>delivery beds) with the or crew and anesthetist at home on call. a 26 y/o >>g3p2 comes to the hospital, with a history of 2 previous cesareans, the >>first for cephalopelvic disproportion. she is unknown to you or the other >>ob/gyn practicing at the hospital. she is 1 cm, ruptured, at term. she >>demands a vbac, and refuses to have a repeat cesarean. > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA Next message: verner nellsch: "Re: vbac on demand" Previous message: rebecca smith: "Re: Methotrexate for ectopic" In reply to: Garry E. Siegel, M.D.: "Re: vbac on demand" Next in thread: Efrain Ramirez: "Re: vbac on demand"

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